It is well known to use rongeurs to remove tissue, e.g., nucleus pulposus, from a region of the spine. For example, U.S. Pat. No. 6,200,320, Michelson, discloses a multi-bite bone cutting rongeur with an ultrathin foot plate and a disposable cutting element and storage chamber unit. Rongeurs are surgical instruments for the cutting away of human tissue, and most commonly, cartilage and/or bone. Rongeurs are known to be used in the spinal canal and about delicate neural structures.
A rongeur with an elongated shaft may be inserted into the intervertebral space of a patient. Jaws on the end of the rongeur may be closed around a portion of the tissue to be removed, a portion of the material may be bitten off by the jaws of the rongeur and the rongeur may be removed from the intervertebral space removing the portion of the material held between the jaws of the rongeur.
This procedure works reasonably well except that the tissue, e.g., nucleus pulposus, has a tendency to break into relatively small pieces when grasped by the jaws of the rongeur. Hence, only a relatively small piece of the tissue may be removed with reach insertion of the rongeur into the intervertebral space and subsequent removal.
Electrosurgical instruments have been used to either cut, e.g., Bovie-style cutting, or to transcollate, coagulate tissue and staunch blood flow.
Some devices have combined a grasping device and the use of electrical energy. For example, U.S. Pat. No. 8,192,432, McGaffigan, discloses a tissue cutting and sealing device, having a pair of opposing elements dimensioned to grasp tissue therebetween and a heating assembly on at least one of the opposing elements. The electrical energy is utilized to heat an object, at least one of the opposing jaws, to seal a vessel.
U.S. Pat. No. 8,211,105, Buysse et al, discloses an electrode assembly for use in combination with an electrosurgical instrument having opposing end effectors and a handle for effecting movement of the end effectors relative to one another. The electrosurgical instrument has a pair of electrodes each having an electrically conductive sealing surface and an insulating substrate. The electrosurgical instrument is used to both mechanically clamp and uses electrical energy to effect hemostasis by heating the tissue and blood vessels to coagulate, cauterize and/or seal tissue.
U.S. Pat. No. 6,073,051, Sharkey et al, discloses an externally guided intervertebral disc apparatus which manipulates tissue at a selected location of an intervertebral disc. In addition to having a distal section with sufficient flexibility to be compliant to the inner wall of the annulus fibrosus but insufficient penetration ability to be advanceable out through the annulus fibrosus, the apparatus transmits electromagnetic energy in order to provide advantageous, controllable heating (without charring or vaporizing).